With an inoperable brain tumor, Bob Tisch wound up at Duke

Susan BrinkLos Angeles Times Staff Writer

Preston Robert Tisch, known as Bob and a co-owner of the New York Giants, had the wherewithal to go anywhere in the world for treatment for his inoperable malignant brain tumor. He was diagnosed with stage IV glioblastoma in August 2004. His son, Steve Tisch, producer of films including "Forrest Gump" and "Risky Business," moved his family from L.A. to New York to be with his parents and take on the task of searching out some faint glimmer of hope for a devastating diagnosis.

"There was a ticking clock," he says. "You have to do something. I took the 'no stone left unturned' approach."

He spread a net of friends and family, each one fanning out to ask questions of their own physicians and friends and offer a roundup of hospital and doctor recommendations. "I came up with a list," he says. "It wasn't a long list, but it was a list. I found all the doctors on the list extremely accessible and generous with their time on the phone."

He interviewed a half dozen leading neuro-oncologists. "These doctors were not auditioning," he says. "This is not a talent show. But I was determined to come back and make a recommendation to my family."

He settled on Duke University Medical Center, he says, lured by the reputation of neuro-oncologist Dr. Henry Friedman, deputy director of the Preston Robert Tisch Brain Tumor Center at Duke. (Henry Friedman works with, but is not related to, Kennedy's neurosurgeon. The brain tumor center was named for Steve Tisch's father when the family made a substantial contribution after his death.) Steve Tisch found Henry Friedman willing to design drug treatments based on his father's individual tumor characteristics, which meant using approved cancer drugs off-label.

For example, the drug Avastin, approved for colon cancer, has been shown in clinical trials to improve survival in some recurrent brain cancer. "But it'll take a long time to be approved (for brain cancer)," Friedman says. "So why wouldn't you add it to treatment for someone with anewly diagnosed disease in the hope that it'll help?"

"I think for malignant primary brain tumors, the majority of people in the world are told at the time of diagnosis that it's hopeless. They're told that nothing they do will result in a meaningful outcome," the neuro-oncologist says. "That drives them to look elsewhere. They're not leaving because they don't like their doctors. They're leaving because they don't like the outcome they're hearing."

The Tisch family was realistic. They didn't expect to find a miraculous cure. Rather, Steve Tisch says, they wanted hope for a good quality of life for as long as possible.

So along with technical expertise and a creative approach, he looked for trust in, and rapport with, a doctor. The first meeting of his father and the doctor, two Brooklyn-bred boys who never lost their accents or New York sense of humor, sealed the deal, Steve Tisch says. "I witnessed these two Brooklyn men bond immediately," Tisch says. "The chemistry created a very strong, and thankfully long-term, relationship."

Preston Robert Tisch died in November 2005. "For the lion's share of those 16 months," Steve Tisch says, "he lived a life he was content with."